Is audit relevant to the medical wards of a teaching hospital

Abstract Background The extended length of stay (LoS) is one of the main causes of hospital infections (HAI), followed by an increase in antibiotics consumption. The final step is the development of multiresistant microorganisms, with a consequent increase in costs for the national healthcare system. Aim of this study is to evaluate the prevalence of HAI and to analyze ATB consumption in a teaching hospital Methods Between 17-21 June 2019 the infection control team collected the clinical records of 425 patients to perform a point of prevalence analysis (PPA). Eligible patients were hospitalized in surgical and medical wards of the teaching Hospital (615 beds) in Siena, Italy. For each patients according to guidelines of European Centers for Disease Control and Prevention (ECDC 4.2) we searched for evidence of HAI and for all indication of ATB consumption. Data were processed using Stata12 Results Overall 425 patients have been analyzed (48.24% female), mean age was 60.88 (SD 26.11) years, mean LoS 8.37 (min 1 max 86) days. Patients were admitted mostly in General Medicine wards (48.94%); 34% underwent surgery. 63.8% of patients had Peripheral Venous Catheter, 20% Central Venous Catheter and 31.06% Urinary Catheter. Twenty-nine HAI were discovered (PPA 6.82%); the higher prevalence (19.23%) was in Intensive Care Unit. LoS (OR:1.07;IC95%1.04-1.1) and devices (OR:2.17;IC95%1.39-3.37) were the two variables that significantly influenced the infection risk. Forty-six percent of all patients received ATB, the most used were third generation Cephalosporines (26,18%), followed by Penicillines (24,73%). The main use was to treat community infections (62.12%), followed by medical prophylaxis (30.81%) Conclusions PPA of HAI was 6.82%, comparable to 2017 national PPA (6.5%); prolonged LoS is probably the main cause of this result. Our analysis showed that ATB consumption was quite high, in agreement with the Italian prevalence (44.9%), but the percentage of medical prophylaxis was still high. Key messages The way to achieve the health care infection control is still long, the length of the hospitalization could be a field to be improved. High consumption of antibiotics for prophylaxis is still the main point to fight in the battle against the multiresistant microorganisms.

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The clinical profile, hematological parameters and liver transaminases of dengue NS1 Ag positive patients admitted to Jaffna Teaching Hospital, Sri Lanka

BMC Research Notes ◽

10.1186/s13104-019-4655-8 ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 1

Author(s):

T. T. P. Jayadas ◽

T. Kumanan ◽

V. Arasaratnam ◽

K. Gajapathy ◽

S. N. Surendran

Keyword(s):

Teaching Hospital ◽

Hematological Parameters ◽

Severe Form ◽

Significant Rise ◽

Liver Transaminase ◽

Clinical Phase ◽

Critical Phase ◽

Liver Transaminases ◽

Medical Wards ◽

Symptoms And Signs

Abstract Objective Objective of the study is to evaluate the on-admission day symptoms and signs, clinical, hematological parameters and liver transaminases of the dengue NS1 positive patients who got admitted on different clinical phases [Febrile phase (day 1–3) and Critical phase(day 4–5)] of dengue at medical wards of Jaffna Teaching Hospital. Results Blood samples were collected from 150 suspected dengue patients from day 1 to 5 of the illness. Seventy-eight patients were positive for dengue NS1, according to the WHO proposed dengue clinical phase framework 37 patients were from febrile phase and 41 patients from critical phase. Patients who admitted on critical phase framework suffered from leukopenia and thrombocytopenia. Nine patients had the evidence of leakage with fever and the leakers had significant rise in hemoglobin, hematocrit and liver transaminase levels which are considered as severe form of the disease.

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Feasibility of mapping of dengue fever patients admitted to medical wards of Teaching Hospital Karapitiya using Google maps®app in mobile phones or tablets

Ceylon Medical Journal ◽

10.4038/cmj.v63i2.8675 ◽

2018 ◽

Vol 63 (2) ◽

pp. 90 ◽

Cited By ~ 2

Author(s):

J. S. Hewavithana ◽

D. R. Palangasinghe ◽

N. J. Dahanayaka

Keyword(s):

Dengue Fever ◽

Mobile Phones ◽

Teaching Hospital ◽

Google Maps ◽

Medical Wards

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Etiologies of Liver Cirrhosis and Their Clinical Presentation among Inpatients in Medical City Complex - Baghdad Teaching Hospital

Global Journal of Health Science ◽

10.5539/gjhs.v13n5p64 ◽

2021 ◽

Vol 13 (5) ◽

pp. 64

Author(s):

Khalid Abdulla Al-Khazraji ◽

Mohammed Kamal Hashim ◽

Mahmood Kamal Hashim ◽

Mohammed Khalid Abdulla ◽

Issam Hadi Khudhair ◽

...

Keyword(s):

Liver Cirrhosis ◽

Teaching Hospital ◽

Wilson Disease ◽

Basic Knowledge ◽

Cross Sectional ◽

Common Presentation ◽

Clinical Presentations ◽

Common Causes ◽

Medical Wards ◽

Work Up

BACKGROUND: Liver cirrhosis is one of common diseases that doctors deal with during working days, so it is important for all doctors to have a basic knowledge about its etiologies, clinical presentations, complications and prognosis. AIM OF THE STUDY: 1) To detect the most common causes of liver cirrhosis among Iraqi patients. 2) To Find the most common clinical presentations and look for any association between them and a particular etiology. 3) To make recommendations regarding screening for the most common etiology among population and deal with it and treat it early prior to development of liver fibrosis and cirrhosis. PATIENT & METHODS: A cross-sectional study was conducted from January 2016 to January 2019. 1000 patients were enrolled in the current study and followed at medical wards at Baghdad teaching hospital, taking detailed history from them including history of alcohol intake, drug history, etc... and sending them for complete work up including Abdominal US, virology screening, autoimmune, Wilson, iron study etc... and calculating Child - Pugh score for each patient. RESULTS: 1) The most common causes of liver cirrhosis are alcoholic liver disease (20%) and HCV (20%) followed by HBV (18%), NAFLD (14%), cryptogenic (14%), AIH (6%), Wilson (4%), PBC (4%). 2) the most common presentation of liver cirrhosis from all causes are ascites (38%) and encephalopathy (38%). followed by bleeding varices (21%), jaundice (11%). 3) HCV was associated significantly with Encephalopathy, NAFLD significantly associated with bleeding varices, Cryptogenic significantly associated with ascites, Wilson disease and PBC significantly associated with jaundice. CONCLUSIONS: HCV and alcoholism are so common among Iraqi patients with liver cirrhosis, while NAFLD cases are commonly related to diabetes mellitus and obesity. Ascites and encephalopathy are the most common presentation at medical wards from all causes of liver cirrhosis. Most cases of liver cirrhosis due to HCV are within middle and elderly. While Wilson disease should be kept at the top of differential diagnosis of liver cirrhosis among young individuals as it is significantly related to young age group. Cryptogenic cases of liver cirrhosis need aggressive work up and screening for uncommon causes.

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The clinical profile, hematological parameters and liver transaminases of Dengue NS1 Ag positive patients admitted to Jaffna Teaching Hospital, Sri Lanka

10.21203/rs.2.10807/v1 ◽

2019 ◽

Author(s):

T. T. P. Jayadas ◽

T. Kumanan ◽

V. Arasaratnam ◽

K. Gajapathy ◽

Sinnathamby Noble Surendran

Keyword(s):

Teaching Hospital ◽

Hematological Parameters ◽

Severe Form ◽

Significant Rise ◽

Severe Thrombocytopenia ◽

Liver Transaminase ◽

Ns1 Antigen ◽

Liver Transaminases ◽

Medical Wards ◽

Symptoms And Signs

Abstract Objective Objective of the study is to evaluate the symptoms and signs and nonspecific clinical and laboratory parameters of the dengue NS1 positive patients on the admission from day1 to day 5 at medical wards of Jaffna Teaching Hospital. Results Blood samples were collected from 150 consecutive suspected dengue patients from day 1 to 5 of the illness. Seventy-eight patients were positive for Dengue NS1. Patients who had NS1 positivity after 3days of illness suffered from severe form of disease and patients with severe thrombocytopenia had significant rise in hemoglobin, hematocrit and liver transaminase levels which are considered as severe form of disease. Severe thrombocytopenia patients had complicated illness. This shows longevity presence of NS1 antigen could lead to severe form of dengue and could be a prognostic marker of dengue outcome.

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